Almost a year and a half since the first earthquake, it’s time to resurrect the old blog.

I got an email this week from the UM/Medishare group who ran the program back then. They’re having trouble staffing the hospital these days and they’re begging for nurses to go back and help out.  I’ve got a couple of commitments in July & August and I need to raise a little bit of money, but I’m planning to go back on August 27th for two weeks.  Hopefully I can go once more before the end of the year.

The tent hospital is gone now.  We will be working at a real hospital.  Hospital Bernard Mevs is in town, a couple of miles from the airport.  Some pictures…

Hospital Bernard Mevs

More pictures from HBM

It’s Friday.  After we completed our shifts, I and three friends took the opportunity to go out and tour the Port Au Prince earthquake damage again.  This time we hired, Fede, a driver at the hospital. Turns out he works for the US Embassy as the driver for one of the high muckety-mucks in the evening and does this on the side to make extra money for his orphanage.

Fede and his wife have an orphanage in a town about 50 miles from PAP and they have 33 kids there ranging in age from 3 to 13. She runs the place with help from family members while he has to remain in PAP most of the time to make money.  I asked if that wasn’t a difficult arrangement and he allowed that it is, but they are committed to the kids in their care. Amazing people!

Amazing how completely some buildings disintegrated.

Fede, (like “Freddy” without the “r”), took us through the main areas again, but then he also drove us around through a lot of the back streets and neighborhoods.   Similar to what we saw downtown, some neighborhoods fared quite well, but right across the street would be another which was flattened.   You can see more of the pictures in the Photo Gallery.

Which way does the wind blow?

I was walking up this road in the camp today and I just had to laugh as it dawned on me…

As you walk up the road in this direction, to your right and about 50 yards away, is the staff tent where we slept and the tables where we would sometimes have our meals, etc.

To your left in this picture you see the isolation tents.  They are where the patients with communicable diseases were housed.  Minor diseases like TB, malaria, and typhoid.

Which way do you suppose the prevailing winds blow most of the time?  Ding, Ding, Ding!  You guessed it!

Really, there is enough separation that there wasn’t any danger, but I did get a kick out of it…

Today is Wednesday.  Yesterday morning, I went over to the ER tent early.  I walked in to find a 3 month old girl who had been burned pretty badly in a house fire.  I guess the mom went out to buy food for the kids and left them alone.  The oldest was four…   Long story short, the older kids started playing with matches…

Sound Asleep... I'm holding an oxygen mask in front of her face here.

She had second and third degree burns over about 18% of her body.  When I started taking care of her, we were trying to get some of the burns cleaned up and naturally she was crying with the pain.  We had to wait for them to open up a bed in the NICU, and I couldn’t stand to listen to her cry so I picked her up to rock her.  Got her to stop in a few minutes and by the time I could take her over to the NICU, she was sound asleep.  Haven’t lost my touch!

I checked on her today and she’s doing pretty well, but life will be harder for her in this society with the disfigurement that she’s sure to have…

Last night a few of us took a ride downtown for about an hour and a half.  I can’t come up with words to adequately describe it.  You see the pictures on TV, but they don’t give you any idea of the scale of the destruction.  Even this long after the quake, the smell of decay lingers.  Many people are still buried in the rubble.  I’ve seen earthquake damage before, but this was sobering.   Strange too, you would see one building that was completely flattened with the ones on either side seemingly untouched.  In another area, an entire block might be gone.  I’m amazed that there wasn’t much fire damage to make it even worse.

The tent cities are amazing.  People are PACKED together, cheek-by-jowl.  The lucky ones live in tents that have been donated by various relief agencies, but even there the tents are literally side by side, touching one another.  We were there in the evening when it was starting to cool off so people were all out socializing.  It was packed!  Lots of folks set up little tables and sell whatever little things they can to make a little bit of money.

It was a humbling 90 minutes…

I didn't expect to fall in love in Haiti!

She came in today scared to death.  11 years old and she has not walked since the original quake.  We did some x-rays and they showed a fracture just below the right knee.  It was completely healed, even having not being treated.  Problem is that she’s been off her feet for so long that the muscles of her legs and arms have atrophied to the point where she doesn’t have the strength to walk or to use crutches.

She was terrified of everything I was doing with her, but eventually something I said made her smile and it utterly transformed her!  I had the translator tell her that she had a beautiful smile and she broke another one, but got shy at the same time.  We were all grinning!  Later, after I spent a fair amount of time teaching her and her family some exercises to strengthen those muscles, I had to teach her how to use the crutches.  That took a while, but she was trying to use them as they left.  As they walked out, I told her mom that now I have a new girlfriend in Haiti.  They laughed and she got shy again.  It was great fun!

We also lost a volunteer today.  He was a 39 year old guy from Oregon.  Big, strapping son of a gun.  Woke up this morning not feeling well, had some breakfast, and decided to lie down for a few minutes.  A friend checked on him a little bit later and found him with agonal respirations and no pulse.  They brought him to us and we worked him hard, but weren’t able to get him back.  That one hit me hard for some reason and I thank God for the balance between that and the story above.

The rest of the day, most of what we saw was dehydrated babies and kids.  LOTS of diarrhea and that just wears the little ones out.  One poor little guy had a temp of 105.1!  That’s an emergency as it can affect the brain if you don’t get the temp down pretty quickly.  He was listless, floppy, and didn’t even complain when we stuck the IV in him.  Not good… We used ice packs, fluids, Motrin, etc. and cooled him right down.  He was a new kid!  Bright, smiling, seemingly happy.

Fantastic!

There are lots of parasites, bugs, and viruses going around now and we are all worried that we are going to see much more of the same over the next weeks and months.  With the cramped living conditions these people are in, once that sort of thing starts going, it can spread like a wildfire.  We are already seeing a lot of malaria and TB.  With the rainy season approaching, it’s worrisome at best.

I’ve gotten a trip into town lined up for tomorrow.  I befriended a Haitian nurse here who lives in Florida.  She has a lot of family here and they are going to take us out and show us the town after work.  Looking forward to it!

No, I don’t perspire.  I sweat like a racehorse!  But this is ridiculous! 

Yesterday was by far the toughest day so far.  It was the day that the majority of the staff switches out and the new folks come in.  That leaves a period of from three to six hours when we are very short-staffed.  We were all geared up for it, so that part of the day went fairly well.  The flight was on time and people got here roughly when we expected them.  On top of that, we had been limiting the patients we accepted to those who were really sick.

What made the day hard was the weather.  Started out a clear day and it was the hottest yet.  We were wilting with the heat until around two or so when a wonderful cloud cover moved in.  That’s been happening for the past couple of days and it really helps.  The wind kicks up a bit and it gets pretty livable.  Ahh, but THIS time there was rain in them thar clouds.  It started in late afternoon and went on for quite a while.  Came down pretty fast.  The ER isn’t at all set up for rain as you’ll be able to see when I get back and am able to post the pictures, (I’ve given up on being able to do it from here…  Sorry).   We had water coming in from EVERYWHERE!

It would have been comical if it wasn’t so serious.  We were trying to treat patients with water coming in through the roof, the windows, and across the ground.  We had buckets to bail, plastic sheets to cover the supply tables, and plastic to put over the patients.  Some of the lights wouldn’t work so I spent about 30 minutes holding a flashlight so that one of the docs could suture up some poor guy’s head.

The local folks just take it all in stride.  Amazing…

Tomorrow we have the other half of the staff switching out.  They do it on Monday and Saturday so that there is some overlap to keep up patient care.  We never know for sure who is coming in with the next group, but I’ve heard that there will be only 20 nurses on this flight and I think there are a lot more than that leaving.  Gulp…

Please pray that it all goes well.

Another sad story…  We had a young guy come in on Friday night, very sick.  I think he was 29 or so and his wife and some others were with him.  He got sicker very quickly and we had quite a time getting him somewhat stabilized and able to breathe.  When the labs came back, it turned out that he had acute lymphocytic leukemia as well as active TB and pneumonias in both lungs.   That’s a particularly lousy combination and we knew it didn’t look good for him.  After a while, I started to wonder if he’d make it til morning.  As it turned out, he didn’t and that was probably a blessing for all concerned.

Imagine taking care of someone in that situation.  They had absolutely no idea.  They thought it was something run of the mill, (like the flu), that just got really bad.  They don’t understand anything about most sickness or how their bodies work.  The cultural differences are massive. You are trying to explain the situation through interpreters.  The interpreters are great guys and do the best they can, but they don’t always understand us or what we want to communicate.  On top of that they have little or no medical knowledge or training.  Most of the time it works fine, but this was frustrating for us and for the patient’s family.  To top it off, I found out that they have a two and a half year old at home.  Rough…

It would be overstating the situation to say that tuberculosis is rampant here, but it sure is prevalent.  We’ve been seeing a lot of that, hepatitis, malaria, and even some sickle-cell. We are as careful as we can be, but we don’t always find out about the TB until the patient has been in the ER for quite a while.  Lots of exposure potential.

I think I’m rambling & you’re probably sick of reading, so more later…  I’ve heard that there are ways to get out of the compound and be driven around to see what it’s like downtown.  A couple of folks did it today and said it they felt safe the whole time.  I guess some of the locals who have been hired here at the hospital have arranged it.  I’m going to try to get a half-day off and give it a try during the week.

Lot’s to write today, but I have to get to my shift pretty soon so I’ll get some of it down.

Last night, I still wasn’t feeling too hot after my little overheating incident so I decided to lie down for ‘a few minutes’.  You know the rest.  Woke up a couple of hours later, missed dinner, etc.  Oh well…   Figured I could miss a meal or two so I got my teeth all cleaned up for the night.  Just then, who shows up, but the Army!  Four guys came in driving a huge pickup and stopped just outside our tent.  They had the thing loaded sky high with big warming containers full of food!  they brought enough barbeque, macaroni and cheese, rolls, and green beans to feed anyone who wanted any.  (Having not seen a vegetable since Miami, the beans were my favorite.)  And all of it was hot!  For desert, they had warm  coconut cookies, (Anne’s favorite!), with chocolate chips.  No one had any clue they were coming.  What a nice thing for them to do!  Real morale booster for the folks here.

I came up with a new gourmet treat this morning!  One of the things I brought along was a box of those little oatmeal packets that you mix with hot water.  The hot water part is a problem.  Haven’t been able to figure out a way to get any.  Well, they’ve put together a little coffee bar.  I had a cup this morning and had a brainstorm about halfway through it.  Yup, you guessed it!  Oatmeal with brown sugar, apples, and raisins in coffee!  Yum!  Didn’t have any bacon or sausage to go with it, but the teriyaki beef jerky fit in just fine.

Breakfast anyone?

A happy story…  When we arrived here, one of the people we found out about was a twelve year old boy who had been here since the earthquake.  He was finally getting to the point where he could be discharged, but no one knew what to do with him.  Apparently, he was the only survivor in his family and had no place to go.  He would ask the nurses and doctors if he could go home with them and it was a real heart-breaker for everyone.  (There are literally hundreds of identical stories here…).  Now for the good part of the story…

Today, while they were looking for an organization who could accept him, an uncle and a cousin showed up at the hospital looking for him.  They had been looking since the earthquake and wouldn’t give up.  (No one knew that they were alive.)  They eventually found him through Unicef.  I think all patients, especially kids, are going into various databases and the Unicef database eventually matched him up with the searching relatives.

A great ending to one story!!!

After having been here a few days, I realize that we are really doing some great work here for these people.  Yes, we have dirt floors, things aren’t as clean as they should be, we don’t have everything we would like to have for them, but under the circumstances the people on these teams are doing pretty heroic work.  I’ve met some incredible professionals and there is tremendous camaraderie among the staff.  No one complains (much) about the conditions, and all have the same goal.  I think we all recognize the incredible stoicism and resilience of the local people and it’s nice to do a little bit to alleviate their suffering.  It’s humbling when they are so grateful for the little things we do for them.

Last night’s shift wasn’t quite as busy as the night before and there weren’t any stories as sad as what I told yesterday.  We actually got out of there just a little after 11 which was good because we had to be back there at 8 this morning.  Slept fast!

I learned today that the most important job I have here is to stay hydrated.  It’s absolutely amazing how much water you can drink and still fall behind.  Working the ER without any air conditioning makes it all the worse.  I got behind on drinking enough today and wound up getting pretty light-headed, (no smart cracks please…).  They had me lie down with an ice pack on my neck and I drank a bunch of Gatorade.  After an hour or so it did the trick.  Just to give an idea, I probably drank 14 or 15 bottles of water and only peed twice all day.  The rest is just perspiration!

After the death the other day, I was looking for a bit of good news so I walked back to the NICU and looked in on the premies.  Like everywhere else here, there were no empty beds, but the kids are sure cute and it was good to see new life, even if it is struggling a bit.

I’ve observed that most of the Haitian people are just wonderful folks.  The cultural differences between us are striking.  The people we are seeing are, in most cases, dirt poor.  They don’t complain about having to wait in line for hours.  If we ask them to do something, they comply without question.  One of the more interesting things I’ve observed is that modesty is not an issue in this setting.  If the doctor needs to do  a very personal exam the patient just says OK and doesn’t care that he/she is in an open ER.  We fall all over ourselves trying to hold up blankets and such, but it seems to amuse them.  Fascinating…

Well, it’s starting to rain and I’m sure the tent is going to leak, (lots of holes up there), so I’m going to put the computer away…

It’s all pretty much a blur since we arrived yesterday morning.  We got in around ten or so.  Customs and Immigration were “interesting”.

At the hospital, we were directed to the staff tent to find a bed.  It’s a huge tent with six long rows of cots.  I’m less than a foot from my newest best friends on either side of me.  I’m taking pictures, but for some reason can’t transfer them from the camera to the computer right now.  I’ll keep working on that, but if I can’t fix it I’ll post them when I get back.

For now, I’m assigned to the ER from 3 to 11 pm.  (In theory…  We were absolutely buried yesterday and I finally left at 1:15am.)  It is extremely busy and very, very basic.  The ER is a tent, open on two sides and not air-conditioned, outside one of the main hospital ward tents.  We have six beds on one side and four on the other with the walkway to the main hospital entrance going right through the middle.  The floors are dirt.  (I have a much better appreciation for the MASH show of way back when!!)  The care we can give is relatively basic, as you might expect in a MASH unit, but we also have access to some really good trauma surgeons and other docs.  The OR is pretty well equipped and can handle all of the basic stuff.

We had several traumas last night as well as a couple of medical emergencies.  The rest of the night was the sort of stuff that goes to the ER these days when they don’t have anywhere else to go.  Sick kids, lacerations, bumps, bruises, etc.  The word is out about the hospital and people really want to be seen here.  Also, lots of the local clinics like to refer their patients here so we were seeing some people show up from 30 or 40 miles away.  For a good portion of the evening every bed was occupied.

One sad story.  We had a young woman come in, very sick, with a “hot abdomen” (which means that there is some kind of big infection going on).  Hot abdomens are always urgent and frequently emergent.  (This girl was probably early 20′s.)  We worked her up to get her ready for the OR, (IV’s, X-Rays, Labs, etc), and then sent her off to surgery.  We learned a couple of hours later that she had died on the table.  Her mother came in, unaware, and obviously just fell apart.  When we got the full story later, it turns out that she lost two other kids during the initial earthquake.

Awful…

Time to get ready for my shift.  I don’t think I’ll be able to keep the blog up every day, but I’m glad that I can at least hit it every other day or two.

This will be quick – a race to see if I can beat the battery dying.  It was a MOST auspicious start yesterday.  I expected to wake up in the staff tent at the hospital in Haiti.  It’s now 0525 on Tuesday and I’ve just woken up on a bench in the terminal of the Santo Domingo Airport in the Dominican Republic.

I got to the airport at about noon yesterday in Miami, started meeting the other folks going down, and we all got checked in eventually for our 3:45 flight.  (It’s still light at 3:45…)  Someone noticed that the flight was changed to 5:45. (It’s starting to get dark at 5:45 ).

Finally took off around six.  Dark in Haiti…  We get overhead Haiti and the pilot comes on the intercom with the two worst words you can hear from the cockpit, “Well, Folks…). It went downhill from there.  The runway lights at the Haiti airport weren’t working.  They were working the problem, but we had a limited amount of go-juice so after holding for about an hour we diverted to Santo Domingo.

This is where we slept in the airport.

Landed in SD and they didn’t know quite what to do with us so they let us sit on the taxiway for about an hour and a half until someone found someone who could make a decision.  Long story short, they let us off the plane into the terminal, but we were not allowed to leave the immediate area. Customs and all that…

It was a lovely night.  I feel for the folks at the Haiti airport who were waiting for this plane to drop us off and take them home. I think most of us got a couple of hours of sleep.  Zombies will be walking the hospital halls today!

We should be able to take off from here about 0730 or so and getting into the Haiti airport during daylight shouldn’t be a problem.

While we were still in Miami yesterday and getting checked in, Each person on the trip was given a purple hospital wristband that we will wear throughout.  When we went to get some dinner before the flight, one of the folks remarked that we must look like asylum patients on a day pass from the home.  I laughed then, but it’s even funnier this morning!

How special!

It’s Sunday in Miami.  Tomorrow noon-ish I’ll meet up with the UM folks back over at the airport.  We’ll be flying Vision Air – never heard of it.  Hope the rubber bands are new…

I had forgotten what a nightmare it is to fly in here, (at least on American from DFW).  The flight itself was great.  We left a little late due to storms in Dallas, but everything went smoothly enough otherwise.  It’s when you get here that the fun begins…  American has a lot of gates here, but for some reason the times I’ve come here from Dallas we’ve always parked at the far end of the “E” concourse.  AA’s baggage claim is usually in the “D” area.  No way to get there but walk – and I’m pretty sure those two places are in different counties!!!

Oh well, they say walking is good for the heart.

Tonight, I’m staying at one of the hotels right at the airport.  Picked it because it was about as cheap as I could get and they have a shuttle from the airport.  All well and good, BUT for the dad-gum TV.  Every channel works just fine EXCEPT the one carrying the Olympic Curling competition!

There is no justice…

That’s the bugs screaming when they see me get off the plane!

I went to see my new best friend, Diane, today and she shot me full of more vaccines.   I feel like I should have a big red “S” tattooed on my chest.  Like Clint Eastwood, but talking to the bugs, “Well, Punks… make my day!”  Good grief!

Here’s where we’ll be working.  This is a static picture below.  If you want to see it in Google Maps, click here.  You’ll see the four white tents just to the right of center and you can zoom in and out, move around, etc.  If you REALLY want to have some fun, you can download Google Earth and install it.  It is AMAZING!!   (Click here if you want to download it. )

University of Miami's Haiti Hospital

The hospital is set up in a field a few hundred yards from the main runway at the airport in Port au Prince.  It consists of the four large white tents that you can see in the photo or Google Maps.  (That’s a covered walkway between the middle two tents.)  A few months ago there was nothing there but grass and trees.  (They told us to bring good shoes and watch out for the remains of tree stumps.)

From right to left, the tents are:  Staff quarters, Main hospital ward, OR/ICU, Supply tent.  The information that they sent me said that conditions are still fairly primitive, although far better than just after the quake.  The quarters are co-ed with a bunch of army-type cots lined up.  Showers may be available every couple of days and they say to bring bathing suits as those are pretty much open too.  Porta-Potties are the order of the day. (Oh, by the way, bring your own TP!) 

Food is pretty much military MRE’s, (meals ready to eat), and they have lots of bottled water.  Thus far there is no coffee, so I’ll be bringing packets of coffee and tea.

Did I mention that the rainy season is starting?  Thanks for all your prayers, y’all…

Of instructions, that is…

I got home this afternoon, checked my email, and found a confirmation letter.  I’ve been confirmed as a participant with the UM program and will be going with them on Monday.  Will leave here Sunday to be sure to get to Miami in plenty of time.

Yikes!  Just made my flight reservations and things have changed.  I used to travel at least once a week, but haven’t in over a year.  Let’s just say that the prices are special!  Thankfully, I found a cheap hotel at the Miami airport for Sunday night.

The 15 pages…  Lots of great info put together by the folks at UM.  I’m going to be busy between now and Sunday.  Need a couple more shots and have to go shopping for some new scrubs.  I haven’t gotten an answer yet to my question about being able to take my laptop along so that I can keep up the blog on a daily basis.

Not sure yet how long I’ll be there.  Right now I’ve scheduled a return flight for March 8th.

I appreciate all of your prayers to this point.  I know some of you have different views than I do, but if you are a person who prays, please keep us in your prayers.

Back on the 11th, I got another call from the University of Miami.  They were updating their database.  I pointed out that they had called before, but my lack of license stopped the process.  She wanted to update the info anyway.

Just after that I saw their story about the premature baby and having to find a work-around for keeping her warm.  It struck me that one of the problems some of their teams are having is that they are out of their element.  They aren’t in the hospital and don’t have all of the things they are used to working with.

Paramedics work out in the field.  That IS their element and they are required to improvise on a regular basis.  I called her back and mentioned that and she said, “Why don’t you write that up the way you want to and send it to me.  I’ll put it right into the database!”  Such a deal!  I sent it off and hadn’t heard anything since.  I had started to wonder again and last night I decided to give it another week and then reevaluate.

This afternoon, I was working on Anne’s blog and I got another email from UofM.  They were checking availability for next week.  I gave them my availability and we’ll see…

Here’s a video of some of these folks working and the conditions they are seeing.  Warning, some of it is a bit graphic!

Click for video

One story: This is a quote from a newsletter I received today from one of the organizations I’m trying to work with.

“Family members carried Evans Monsigrace into Project Medishare and University of Miami’s Global Institute Hospital in Port-au-Prince Monday night after being pulled from the rubble 27 days after the earthquake. The 28-year-old had been selling rice when the quake destroyed the market where he was working. For four weeks he was trapped in a void of rubble. A large boulder, his only obstacle to freedom. Although trapped, Evans was able to move and gain access to minimal amounts of food and water helping him patiently wait for hopes of rescue.

He arrived at our trauma facility bone-thin and dehydrated, but after a night of fluids and care from the Project Medishare and University of Miami volunteers, he remains in stable condition in the hospital’s intensive care unit.”

From another account of the same incident…

“Monsigrace came into the Project Medishare/UM Global Institute Hospital bone thin, dehydrated, and delirious asking doctors to let him die.  Monsigrace said he is thankful to God for giving him a second life.”

Another great story…

One of the big problems the medical teams have is that they are working without the facilities and equipment that they are used to having in their hospitals.  ( A lot like paramedics working out in the field! LOL…)

“Last week, volunteer medical teams lacked an incubator after delivering a premature baby by C-section, but came up with an ingenious warming solution by using MRE’s to warm the baby.  The military’s Meals-Ready-to-Eat come with flameless heaters that use a simple chemical reaction to warm food. Project Medishare’s volunteer medical team from the University of Miami continue to work creatively like this to provide the best care possible to these earthquake victims, but appropriate equipment and supplies are still needed.”

What ingenuity!  Fantastic!